Pharmacokinetics of Liposomal Amphotericin B in Pleural Fluid

Author:

Moriyama Brad1,Torabi-Parizi Parizad2,Pratt Alexandra K.2,Henning Stacey A.1,Pennick Gennethel3,Shea Yvonne R.4,Roy Chowdhuri Sinchita5,Rinaldi Michael G.3,Barrett A. John6,Walsh Thomas J.5

Affiliation:

1. NIH Clinical Center Pharmacy Department, Bethesda, Maryland

2. Critical Care Medicine Department, Bethesda, Maryland

3. University of Texas Health Science Center, San Antonio, Texas

4. Department of Laboratory Medicine, Bethesda, Maryland

5. National Cancer Institute, Bethesda, Maryland

6. National Heart Lung and Blood Institute, Bethesda, Maryland

Abstract

ABSTRACT We report the penetration of liposomal amphotericin B into the pleural fluid of a patient with pulmonary zygomycosis and empyema. The ratio of area under the concentration-versus-time curve in pleural fluid (AUC pleural fluid ) to that in serum (AUC serum ) for liposomal amphotericin B over 24 h was 9.4%, with pleural fluid concentrations of 2.12 to 4.91 μg/ml. Given the relatively low level of intrapleural penetration of liposomal amphotericin B, chest tube drainage may be warranted for successful treatment of zygomycotic empyema.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

Reference22 articles.

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3. Chamilos, G., E. M. Marom, R. E. Lewis, M. S. Lionakis, and D. P. Kontoyiannis. 2005. Predictors of pulmonary zygomycosis versus invasive pulmonary aspergillosis in patients with cancer. Clin. Infect. Dis.41:60-66.

4. Chamilos, G., M. Luna, R. E. Lewis, G. P. Bodey, R. Chemaly, J. J. Tarrand, A. Safdar, I. I. Raad, and D. P. Kontoyiannis. 2006. Invasive fungal infections in patients with hematologic malignancies in a tertiary care cancer center: an autopsy study over a 15-year period (1989-2003). Haematologica91:986-989.

5. Cooke, D. T., F. D. Pagani, D. R. Kaul, K. R. Cooke, C. L. Lau, and J. Riddell IV. 2009. Successful treatment of pulmonary zygomycosis in two transplant recipients with liposomal amphotericin B and partial surgical resection followed by posaconazole. Mycoses53:163-167.

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